Frieden T R, Mangi R J
Infectious Disease Section, Yale University School of Medicine, New Haven, Conn.
JAMA. 1990 Sep 19;264(11):1438-40.
More than $2.4 billion is spent annually on oral antibiotics. Their inappropriate use is common, and newer ones offer expanded and expensive opportunities for abuse. Ciprofloxacin, an oral quinolone with systemic absorption and broad antimicrobial spectrum, illustrates this pattern. Since its release in the US in October 1987, ciprofloxacin has rapidly become one of the most frequently prescribed oral antibiotics. We have observed widespread inappropriate use of ciprofloxacin and describe several patterns of misuse. The activity of ciprofloxacin against streptococci, anaerobic organisms, and Mycoplasma ranges from intermediate to poor. Properly used, ciprofloxacin can extend the range of oral therapy. However, ciprofloxacin is inappropriate initial therapy for common outpatient infections, including otitis media, sinusitis, pharyngitis, and pneumonia.
每年在口服抗生素上的花费超过24亿美元。其使用不当的情况很常见，而且新型抗生素为滥用提供了更多且昂贵的机会。环丙沙星是一种具有全身吸收且抗菌谱广的口服喹诺酮类药物，就体现了这种情况。自1987年10月在美国上市以来，环丙沙星迅速成为最常处方的口服抗生素之一。我们观察到环丙沙星存在广泛的不当使用情况，并描述了几种误用模式。环丙沙星对链球菌、厌氧菌和支原体的活性从中度到较差。正确使用时，环丙沙星可以扩大口服治疗的范围。然而，环丙沙星对于常见的门诊感染，包括中耳炎、鼻窦炎、咽炎和肺炎，并不是合适的初始治疗药物。
